330: Dor Podcast: TEAM with TOTS

Integrating TEAM-CBT with Martial Arts Training! Podcast Episode 330, Featuring Dor Star Our guest today is Dor Star. Dor is an educational counselor (MA) and a level 2 TEAM practitioner who works with children in Israel who have emotional and interpersonal problem. He works with children as young as four years old, but most of his work is with children ages seven to twelve years old. The children he works with experience various challenges and difficulties such as: Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), learning disabilities, tantrums, outbursts of anger, all kinds of anxieties, social difficulty, bullying and much more. His work is unique because he works mainly in small groups (4-6 participants) using martial arts and sports as therapeutic tools. In his work Dor uses the TEAM model with some adaptation, because of the children’s ages and sports methods, with great success! In fact, one can say that he discovered for himself, and for his patients, a new way to use the TEAM model. He also teaches sports and martial arts trainers who are interested in entering the field of child therapy. Dor describes his first encounter with TEAM-CBT, which blew him away, but he was initially frustrated because he was thinking of his conventional ways of dealing with kids VS TEAM. But after a few weeks he discovered that he could use the TEAM structure to improve his approach, and wow, did he ever start to shine, as did his results with TEAM. Today’s podcast was really a breath of fresh air! Dor began with T = Testing, and describes how he developed simple assessment tools to rate how his children (aged 4 to 11) were feeling at the start and end of his classes, but also how they felt about him. He uses simple questions like “Did I understand you today? How well did I listen?” He also asks them, “How much fun was the session,” and “How did you grade yourself?” Then they grade him on a scale from 0 (the worst) to 10 (the best.) So, it’s quick, easy, and . . . shocking. Dor says: “I found out that I wasn’t nearly as effective as I thought. Sometimes the kids thought the class was fun, but I got really low grades on Empathy, as well as how depressed, anxious and angry they were feeling at the start and end of each group session. Essentially, I discovered that I wasn’t achieving almost any of my goals for my kids. This was disturbing at first, and I had to let my ego die. But I decided to try to view it as valuable information that I might be able to use to learn and grow.” For example, I had one of the most amazing sessions with an 11 year who was smiling the entire time. I was absolutely certain it was one of my best sessions ever. But when I asked him for my grade, he gave me a 3 out of 10! When I asked why, he explained that at the start I didn’t introduce myself or ask him about himself! So, in this simple but compelling way, Dor has used the T = Testing to transform the entire way he works with kids! I believe he’s had the same experiences I’ve had with the T = Testing component of TEAM. Dor has made his patients his teachers, and this has led to some amazing and revolutionary developments in his approach. Dor emphasizes the importance of E = Empathy, and says that “the Five Secrets of Effective Communication” are incredible! For example, if they’re having a rage attack, or a temper tantrum, you can tell them they are absolutely right in the way they’re thinking and feeling.” He also uses what he calls the Five Ways of Love.

1. Verbally expressing respect and liking
2. Giving service: tying a child’s shoes, giving them some water during the training. These small acts can create feelings of trust and connection.
3. Spending time with them, paying attention to them. This is especially important because so many are angry and try to push others away. They are good at getting other people to reject them and not want to spend time with them.
4. Giving gifts, something they can take home and show to their parents.
5. Making physical contact with them during the martial arts training, playing with them, having fun.

I (David) would note that physical contact might be something to be careful with. Of course, when you are teaching martial arts, it may be perfectly justified and desirable. I came from the psychotherapy perspective, and I have been trained that ANY touching of a patient other than shaking hands at the initial and final sessions is grounds for a malpractice suit as well as an ethics charge. Dor also made some really illuminating comments on the A = Assessment of Resistance (formerly called Paradoxical Agenda Setting.) At the initial evaluation, he talks to the teachers, parents, and students. The agendas from teachers and parents are things like “he has an anger problem” or a problem paying attention in class, or whatever. However, 90% of the time, the children frequently are unaware of those agendas, or have no interest in the goals of the teachers and parents. Instead, he finds out what the children want to work on, and finds this to be the most and only effective way to approach the treatment. He says that it is fairly easy to set goals with children of any age, even as young as 4 years old, but those in the 8 to 11 years of age are the most difficult. He said that the children’s goals may be to learn how to hit back when they are being bullied in school, or to have fun and make friends with other kids. I was delighted to hear about Dor’s methods of setting goals with his kids and have felt strongly along these lines for many years! I say, Kudos, Dor! He also described doing a Cost-Benefit Analysis of crying when being bullied, and also helps his children see the positives in their symptoms using Positive Reframing. Dor explains: For example, I worked with a child who was bullied at school. In order for the work to be effective, I asked that the boy who bullied him be included in the group as well. After seeing the bullying happening in real time, I had two private five minute sessions with each child while the other kids played. In these sessions I used empathy techniques and received a score of 10 I started fooling around with the TEAM-CBT Agenda-Setting techniques. The goal was for the child who suffers from bullying to choose to behave in a different way. The child said he was willing to do it to prove to me that he is strong and to get back at the kids who beat him. I then talked to the bully boy and asked him if he was willing to help me work with that boy. He was happy to do it because he wanted him to stop crying all the time and get punished for it. After that the M = Methods part was really easy and fun. I hade the bully train the kid =whom he’d bulled. Two meetings after that they were best friends. In my experience (and I have done this process several times) the bully is the best therapist for a child who suffers from bullying! After Dor described his approach to helping kids who are being bullied, he said that if the parents or authorities step in to help it can make things worse because they child is placed in the role of being a baby, which may intensify the bullying. David asks: Dor, is a safety plan for the child important? Can the child always learn to deal with the bullying on their own? Any details or examples would be great! This was Dor’s answer: I didn't address it enough, but you can't provide good therapy without providing good education. That's why I like working in schools because I can easily talk to the teachers. It is clear that we as adults need to talk about values and set boundaries, and in severe cases we may need to intervene and provide a safety net for the therapeutic process. But I feel that it is my job as a therapist to give my patient the tools to deal with their problems on their own. And bullying, like any problem in a relationship, is about guilt. And as soon as I stop blaming the other and start trying to improve myself and treat the other and his wishes with respect the change begins to happen. David: I agree strongly with what you just said! My research when I was in Philadelphia years back strongly supported the notion that blame is one of the main causes of relationship conflicts. Dor continues: In another case of mine, I worked with a child who complained that whoever was sitting on him was yelling at him and throwing things at him. I wasn't sure what could be done and gave him all kinds of bad suggestions At this point a 10-year-old boy with autism stopped me () and asked him what he asked the boy who was bothering him. He said that the he was criticized for the exact same thing--he was making noises that disturbed the boy next to him. From there we continued with homework to find out what is bothering that child, to tell him that he is right, and to ask him if he is ready to stop hitting and yelling at the second patient and his behavior will change. It was a huge success. Dor continues to talk about the idea of specificity which is so central to TEAM-CBT: I discovered that the techniques we teach children should be direct and simple. In the past we believed in all kinds of indirect techniques that were supposed to somehow help the child. The idea is to stop using general definitions like "self-confidence" "concentration abilities" and "social problems." Instead, we can start being specific in our goals and techniques. Rhonda and I were thrilled to learn about Dor’s terrific work adapting TEAM to working with very young people. I encouraged Dor to consider a book on TEAM for TOTS (or some other title) so other therapists can learn how to adapt TEAM to work with children with specific problems such as intense shyness, autism spectrum problem, ADHD, anger issues, and more. Several days after the recording session, Dor was already working on his book. Awesome! Thanks so much for listening today! Rhonda, Dor, and David If you wish to contact Dor, you can email him at: dorstra@gmail.com